Scoping review of intensive psychiatric inpatient care provision for young people in Scotland: report

4 Adolescent IPCU Admission data - For the period of 2016 -2020

4.1 Admissions to Adult IPCU Provision

Table 1 indicates the number of admissions of young people to Adult IPCUs for the period of 2016 to 2020 (for the second half of 2020, data was only available from the North of Scotland).

Table 1: Adolescent Admissions to Adult IPCUs.

Table 1: Adolescent Admissions to Adult IPCUs

Region of IPCU	Accepted Adolescent Admissions to Adult IPCUs	Adolescent Referrals to Adult IPCUs that were not accepted
North	17*	10
South East	2	2
West	11	2

*Five of these were identified as not requiring the level of security of an IPCU, and were mostly due to bed shortages. One of these was a Tayside patient who was admitted to an IPCU in a different region.

Although numbers in Table 1 are small they are likely to underestimate the true number of patients who require this intensive level of care. As mentioned in previous sections, some patients who require IPCU are instead nursed in the open ward if an adult ward is deemed to be inappropriate. These patients are not accounted for in this table.

4.2 Demographics

4.2.1 Age

Data indicating the ages of patients at the time of their admission was available for 27 of the 30 referrals of young people accepted to adult IPCU provision. Of these admissions, patients ranged from 15 to 17 years of age, four of these admissions were patients who were 15 years old.

4.2.2 Gender

Data gathered on gender of patients who were admitted to adult IPCU provision is listed in Table 2. Figure 1 shows a breakdown of admissions by patient age and by gender

Table 2: Breakdown of admissions of adolescents to adult IPCUs according to gender.

Gender	Number of admissions of young people to adult IPCU
Male	17
Female	10
Data does not specify	3

 

Of the 17 male admissions, three were 15 years old, four were 16 years old and ten were 17 years old.

Of the 10 female admissions, one was 15 years old, six were 16 years old and three were 17 years old.

4.2.3 Duration of Admission

Data on duration of admission was available for 12 of the admissions of young people to IPCU (see Figure 2). Admission length ranged from 1 day to 201 days, mean length was 42.75 days, median length was 11.5. This indicates that the majority of admissions only last a few weeks or even days, however, occasionally admissions will last for a number of months.

  

4.3 Diagnoses and presenting problems

Based on information gathered from the North and West of Scotland regions, Table 3 shows the diagnoses of young people who were admitted to IPCU.

Table 3: Summary of Diagnoses of Young People admitted to Adult IPCU provision.

Diagnoses:

• Psychosis (including drug induced)
• Developmental Trauma (and acute stress)
• Depression
• Paranoid Schizophrenia
• EUPD*

*All individuals with EUPD were admitted due to bed shortages

Table 4 notes the presenting problems that staff have indicated are the reason that a young person was admitted to an adult IPCU provision throughout Scotland.

Table 4: Summary of Presenting Problems of Young People admitted to Adult IPCUs.

Presenting Problems:

• Aggression (towards staff, property, and/or community)
• Suicidal
• (Significant) Violent risk towards staff and patients
• Risk to staff due to psychosis and delusions
• Prison Order
• Absconsion
• Mania symptoms, delusions and/or aggression due to psychosis
• Risk to self (due to paranoid schizophrenia)